ATTITUDES OF PEDIATRICIANS AND PEDIATRIC RESIDENTS TOWARD OBTAINING PERMISSION FOR AUTOPSY

Objective: To investigate attending physician and resident attitudes a nd factors affecting autopsy consent. Methods: A validated, self-repor t, multiple-choice questionnaire was administered to 158 physicians. R esults: The overall response rate was 113 (72%), with 57 (85%) of 67 p ediatric residents and 51 (56%) of 98 attending physicians responding. The status of five respondents was unknown. Most respondents (98%) be lieved autopsies provide valuable information; physicians who had grad uated before 1980 were more likely to believe that the benefits of aut opsy should be taught (P less than or equal to.002). Autopsy was consi dered unnecessary by 20% (22/112) when the disease was known before de ath and by 11% (12/112) when the patient was designated ''do not resus citate.'' Physicians who did not attend an autopsy while in training w ere less likely to believe in the benefits of autopsy (P less than or equal to.02). Factors that influenced the failure to obtain consent fo r an autopsy were physician belief that the family felt the body would be desecrated (30/81 [37%]); physician belief that the family would b e upset (36/104 [35%]); and physician belief that little information w ould be obtained (19/104 [18%]). Fourteen (17%) of 81 physicians indic ated that they do not ask permission for autopsy if the family is upse t. Conclusion: Most physicians believe autopsies have benefit. If the autopsy rate is to improve, physicians in training will require increa sed exposure to autopsies, education regarding the potential benefits, and enhancement of interpersonal skills for successful communication with families in crisis.